Laserfiche WebLink
17 MONITORING WELL INSTALLATION REI-�rcT <br /> i <br />' i <br /> {{ I � <br /> Date: l ` � � CONSTRUCTION <br /> Premise Address : l STotal Depth b2 <br /> Screen Length (from) Co (to) L e � <br /> Well No. : W"w L Filter Pack (from) x1$ (to) L,1 <br /> Bentonite (from) 4S ' (to) 48 ' <br /> nspector: <br /> ��� t/ Cj" b r ( : 4 c Grour (from)q s (to) <br /> Drilling rig type lb $ /> <br /> Permit No ,. (L 1: OOH gB Auger O .D. 15� ' ID , <br /> Completion - Stove pipe/christie box (circle one) <br /> Drilling Company: C�W50 � ru1 l V1 <br /> i �Yry � � casing <br /> Driller. f ' he _ghc <br /> IV <br /> ConsultantI f <br /> Geologist 1 L 'M Lw'AAgcVE-.;ACUNO \\ <br /> =NV ETICN CW31 -3CX <br /> CQMPI='TiCN <br /> SPECIAL PERMIT INFO . G= <br /> d S+r(aca <br /> r <br /> n� <br /> Distance to sewer line <br /> Domestic well on site - ( yl- <br /> If yes , location and distance - • t_ <br /> D ft. <br /> SAMPLING <br /> uccn — <br /> Holding Temperature = N°� <br /> Method <br /> Screening Method = _ <br /> Tracking Sheet - ( y / n ) <br /> SPOILS <br /> Storage Method MATF_.RIALS/DEVELOPMENT <br /> Contamination Noted - ( y / n ) <br /> Storage Location Casing type �V ` , E S� <br /> Blank —T fr. Screen iT <br /> Star size oA VZ <br /> GROUTING Bags cement l6 rsw d Sys 7�Ty✓z <br /> Buckets bentonire ^L fsz u&� S <br /> Depth to water Bags sand/gravel i ea &8p <br /> Mix RatiosFilter Pads typesize <br /> a <br /> Installation Meth— Surge Block: . C y / n ) <br /> Quantity Installed q O S Discussed with geologist: - ( y / n ) <br /> Type of merhod <br /> EH 29 29 Spm 1 Wh <br />